Individual provider Active NPI

Justine A Bello, M.D.

  • Family Medicine Physician
  • Laguna Niguel, CA
National Provider Identifier
1629237276
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A116375 Issued in CA
Practice address
27231 La Paz Rd
Ste a
Laguna Niguel, CA 92677-3627
Phone
(949) 643-9111
Fax
(949) 643-8916
NPI assigned
Jun 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD435375 PA
Family Medicine Physician 207Q00000X A116375 CA Primary

Addresses

Primary practice location

27231 La Paz Rd
Ste a
Laguna Niguel, CA 92677-3627

Mailing address

27231 La Paz Rd
Ste a
Laguna Niguel, CA 92677-3627
Phone (949) 643-9111

Other identifiers 1

IdentifierTypeStateIssuer
A116375OtherCACA MEDICAL LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbello1373995@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160816001904 CA Practitioner - Family Practice 5395898852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

24321 Avenida de la Carlota
Laguna Hills, CA 92653-3681
Phone (949) 204-3006

26800 Crown Valley Pkwy
Mission Viejo, CA 92691-6384

27231 La Paz Rd
Suite a
Laguna Niguel, CA 92677-3627
Phone (949) 643-9111

Hospital & facility affiliations

  • Providence at Home With Compassus Home Health Orange County Home health agency, Anaheim, CA, CCN 057600
  • Providence Mission Hospital Hospital, Mission Viejo, CA, CCN 050567
  • Memorialcare Saddleback Medical Center Hospital, Laguna Hills, CA, CCN 050603

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A116375CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Family Medicine CurrentSince Jul 11, 2016 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Mission Hospital Regional Medical Center Past Accepting new patients
Providence Medical Foundation Family Medicine Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 400
Anaheim, CA 92805

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

27231 La Paz Rd
Ste A
Laguna Niguel, CA 92677
Phone (949) 643-9111

26800 Crown Valley Pkwy
Ste 300
Mission Viejo, CA 92691

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1629237276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27231 LA PAZ RD",
            "address_2": "STE A",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926773627",
            "telephone_number": "949-643-9111",
            "fax_number": "949-643-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27231 LA PAZ RD",
            "address_2": "STE A",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "postal_code": "926773627",
            "telephone_number": "949-643-9111",
            "fax_number": "949-643-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLO",
        "first_name": "JUSTINE",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-07",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD435375",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A116375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA MEDICAL LICENSE",
            "identifier": "A116375",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbello1373995@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "27231 LA PAZ RD",
            "address_2": "STE A",
            "city": "LAGUNA NIGUEL",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926773627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Laguna Niguel, CA

Sources for this page

Verify at the official NPI Registry.